Category Archives: Health Care Reform: Payment Reform

H.R. 2: Medicare Access and CHIP Reauthorization Act of 2015

Here is the full text of the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, which repealed the Sustainable Growth Rate formula for Medicare provider payments.  The bill was signed into law as Public Law 114-10 by President Barack … Continue reading

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U.S. Department of Health and Human Services: Goal of 50% Medicare Provider Payments Based on Alternate Payment Models by 2018

In this January 2015 blog posting, Health and Human Services Secretary Sylvia Mathews Burwell announced departmental goals of changing 30% of Medicare provider payments to alternate payment models by 2016, and to 50% by 2018.  A secondary set of goals … Continue reading

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Centers for Medicare & Medicaid Services: Proposed Medicare Bundled Payments for Hip and Knee Replacements

The Centers for Medicare and Medicaid Services has a proposed change in its Medicare fee-for-service payments that would use a bundled payment methodology for hip replacements and knee replacements, called the Comprehensive Care for Joint Replacement Payment Model.  According to … Continue reading

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Center for Medicare and Medicaid Innovation: 11 States Awarded State Innovation Model Implementation Grants; 17 States, DC and 3 Territories Receive Planning Grants

The Center for Medicare and Medicaid Innovation has announced Round Two awards for the State Innovation Model, authorized by section 3201 of the Affordable Care Act, with 4-year implementation (test) awards to 11 states: Colorado, Connecticut, Delaware, Idaho, Iowa, Michigan, New … Continue reading

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Peterson Center on Healthcare Launched to Transform U.S. Healthcare

Today the Peter G. Peterson Foundation announced the launch of the Peterson Center on Healthcare, a new organization dedicated to transforming U.S. healthcare into a high-performance system that delivers high-quality care at a lower cost. With an initial commitment of $200 … Continue reading

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Advocacy to Make Increased Medicaid Primary Care Payments Permanent

National primary care physician organizations, including the American College of Physicians, American Academy of Family Physicians, and American Academy of Pediatrics, have taken policy positions supporting making permanent the increased Medicaid primary care payments for calendar years 2013 and 2014 under … Continue reading

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Kaiser Family Foundation: Medicaid Financing – Overview of the Federal Medicaid Matching Rate

This policy brief from the Kaiser Family Foundation describes the Federal Medical Assistance Percentage (FMAP), or the federal matching rate for the Medicaid program. The FMAP is generally 50% for the majority of states, but as high as 74% for … Continue reading

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American Hospital Association: Your Hospital’s Path to the Second Curve – Integration and Transformation

This issue brief from the American Hospital Association (AHA) describes the need for hospitals to transform from volume-based payments to value-based revenue and business models. Environmental pressures are driving hospitals and care systems toward greater clinical integration, more financial risk … Continue reading

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Health Research & Education Trust: Second Curve Roadmap for Health Care

This “roadmap” from the Health Research & Education Trust of the American Hospital Association uses a futurist framework to describe the coming of the “second curve” (phase) for health care organizations, moving from a “first curve” of volume-based, largely fee-for-service … Continue reading

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Health Research & Education Trust: Metrics for the Second Curve of Health Care

This report from the American Hospital Association’s Health Research and Education Trust describes how hospitals and health systems will need to shift from a “first curve” of primarily fee-for-service, volume-based payments to a “second curve” of value-based payments based on … Continue reading

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